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专有管理与更高的再入院率:相关性。

Proprietary management and higher readmission rates: A correlation.

机构信息

Department of Pharmacology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America.

Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States of America.

出版信息

PLoS One. 2018 Sep 18;13(9):e0204272. doi: 10.1371/journal.pone.0204272. eCollection 2018.

Abstract

INTRODUCTION

Reducing preventable readmissions among Medicare beneficiaries is an effective way to not only reduce the exorbitantly rising cost in healthcare but also as a measure to improve the quality of patient care. Many of the previous efforts in reducing readmission rate of patients have not been very successful because of ill-defined quality measures, improper data collection methods and lack of effective strategies based on data driven solutions.

METHODS

In this study, we analyzed the readmission data of patients for six major diseases including acute myocardial infarction (AMI), heart failure (HF), coronary artery bypass graft (CABG), pneumonia (PN), chronic obstructive pulmonary disease (COPD), and total hip arthroplasty and/or total knee arthroplasty (THA/TKA) from the Center for Medicare and Medicaid Readmissions Reduction Program (HRRP) program for the period 2012-2015 in context with the ownership structure of the hospitals.

RESULTS

Our analysis demonstrates that the readmission rates of patients were statistically higher in proprietary (for profit) hospitals compared to the government and non-profit hospitals which was independent of their geographical distribution across all six major diseases.

CONCLUSION

This finding we believe has strong implications for policy makers to mitigate any potential risks in the quality of patient care arising from unintended revenue pressure in healthcare institutions.

摘要

简介

降低医疗保险受益人的可预防再入院率不仅是降低医疗保健成本的有效方法,也是提高患者护理质量的措施。由于质量衡量标准不明确、数据收集方法不当以及缺乏基于数据驱动解决方案的有效策略,之前许多降低患者再入院率的努力都没有取得很大的成功。

方法

在这项研究中,我们分析了医疗保险和医疗补助减少再入院计划(HRRP)项目中 2012 年至 2015 年期间包括急性心肌梗死(AMI)、心力衰竭(HF)、冠状动脉旁路移植术(CABG)、肺炎(PN)、慢性阻塞性肺疾病(COPD)以及全髋关节置换术和/或全膝关节置换术(THA/TKA)在内的六种主要疾病的患者再入院数据,并结合医院的所有制结构进行了分析。

结果

我们的分析表明,与政府和非营利性医院相比,在所有六种主要疾病中,患者在私营(盈利)医院的再入院率统计学上更高,这与它们在地理位置上的分布无关。

结论

我们认为,这一发现对政策制定者具有重要意义,可以减轻医疗机构因收入压力而对患者护理质量产生的任何潜在风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8a4/6143254/28a540a1df8f/pone.0204272.g001.jpg

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